National Account Director – Government Payers, Medicaid

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and manage Fee-for-Service Medicaid, Managed Medicaid, Medicaid Buying Pools, and other designated accounts.

• Cultivate and sustain relationships with key decision-makers within accounts, including medical and pharmacy departments.

• Implement account strategies and tactics while supporting regional field matrix teams.

• Develop relationships with P&T, Medical and Pharmacy Directors, and stakeholders focused on population health to ensure access and product positioning.

• Formulate state Medicaid access strategies across fee-for-service programs, managed care organizations, and states with single preferred drug lists.

• Navigate prior authorization requirements, step edits, preferred drug lists, P&T committee submissions, and Drug Utilization Review boards.

• Address state-level billing requirements for physician-administered drugs, NDC-to-HCPCS crosswalks, and claims processes.

• Monitor developments in Medicaid policy, supplemental rebates, multi-state purchasing pools, and managed-care carve-in/carve-out dynamics.

• Collaborate with field reimbursement and patient services teams on benefits investigations, prior authorization assistance, denials, and appeals resources.

• Work alongside HEOR and Medical Affairs on real-world evidence and economic analyses pertaining to Medicaid populations.

• Support Regional Sales teams with pull-or-sell-through strategies based on payer coverage.

• Lead both internal and external discussions regarding access, coverage, and reimbursement strategies.

• Promote accountability, urgency, ethical conduct, and professional development within the field team.

• Conduct activities in compliance with the Anti-Kickback Statute, False Claims Act, FDA promotional regulations, government price reporting requirements, PhRMA Code, and Summit compliance policies.

• Carry out other assigned tasks as needed.

⛳️ Requirements

• A Bachelor's degree is required; an MBA, PharmD, or other advanced degree is preferred.

• A minimum of 10+ years of experience in the biopharmaceutical industry, with at least 5+ years in roles related to government payer, reimbursement, or policy.

• At least 5+ years of experience in Oncology or immuno-oncology account management.

• Proven success in engaging with US Payers.

• Strong understanding of the US healthcare payer/access landscape and regulatory environment.

• Excellent strategic thinking, leadership, negotiation, and relationship management abilities.

• Capability to collaborate with cross-functional teams and drive complex projects to completion.

• Exceptional communication and presentation skills.

• Willingness to travel as necessary to support business priorities.

• Proficient knowledge of the Medicaid Drug Rebate Program, AMP/Best Price mechanics, and state Medicaid utilization management.

• Experience in launching a buy-and-bill specialty or oncology product into the U.S. government payer channel.

• Ability to interpret regulations and effectively convey them into commercial strategies for non-technical audiences.

• Demonstrated history of achieving and maintaining compliance with all relevant regulatory, legal, and operational guidelines.

• Capacity to work efficiently in a fast-paced, dynamic environment while balancing multiple priorities and meeting deadlines.

• Preferred: Experience with Oncology Buy & Bill launches, particularly through the transitional coding phase.

• Preferred: Previous experience working with Medicaid.

• Preferred: Background in establishing a government payer function at a pre-commercial or newly commercial company.

🏝️ Benefits

• Bonus, stock options, benefits, and/or other applicable variable compensation may be included in the overall compensation package.

• Equal Opportunity Employer.